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General NPI Number Information
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NPI Number | 1922449669
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Entity Type | Organization
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Legal Business Name | MARTIN COUNSELING ENTERPRISES, INC.
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 11400 OVERSEAS HWY STE 224
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City | MARATHON
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State | FL
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Zip | 33050-3600
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Country | US
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Telephone | 305-906-0238
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Fax | 305-434-9040
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Provider Business Mailing Address
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Address Line | 11400 OVERSEAS HWY STE 224
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City | MARATHON
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State | FL
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Zip | 33050-3600
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Country | US
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Telephone | 305-906-0238
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Fax | 305-434-9040
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Authorized Official
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Title or Position | LICENSED CLINICAL SOCIAL WORKER
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Name | MR. WILLIAM CHARLES MARTIN
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Credential | LCSW
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Telephone | 305-906-0238
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW6660
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License Number State | FL
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